Abdominal pain is a symptom that occurs during the course of many acute and chronic illnesses.
Abdominal pain may vary in severity and duration. It may resolve before a diagnosis can be made or may be indicative of a severe, life-threatening condition. Sudden onset of severe abdominal pain may require hospitalization for control of symptoms and diagnosis of the underlying condition. Chronic abdominal pain does not usually require hospitalization for treatment or diagnosis.
Pain may be diffused over the entire abdomen or may be localized to the right or left side and/or the upper or lower quadrants. The source of abdominal pain is often difficult to pinpoint and may, in fact, not involve abdominal organs (liver, gall bladder, intestines or spleen). Abdominal pain can originate in another part of the body such as the lungs (pleurisy, pneumonia), heart (myocardial infarction, endocarditis, pericarditis), pelvic region or spine (osteomyelitis, nerve root pain). Several causes of abdominal pain (e.g., ascending cholangitis, acute pancreatitis, acute mesenteric ischemia, ruptured aortic aneurysm) are associated with high morbidity and mortality and require immediate evaluation and treatment.
The term "acute abdomen" refers to an episode of severe abdominal pain that lasts for several hours or longer, may be accompanied by other signs and symptoms, and requires immediate medical attention. Examples of conditions causing an acute abdomen include gastrointestinal tract disorders (perforated gastric or duodenal ulcer, appendicitis, bowel obstruction, pseudo-obstruction, bowel perforation, incarcerated hernia); liver, spleen, and biliary tract disorders (acute cholecystitis, acute cholangitis, biliary colic, hepatic abscess, splenic infarct or rupture); pancreatic disorders (acute pancreatitis); urinary tract disorders (renal colic, acute pyelonephritis, perinephric abscess); vascular disorders (ruptured aortic aneurysm, mesenteric ischemia/thrombosis); and peritoneal disorders (peritonitis and intra-abdominal abscess). Additional causes of acute abdominal symptoms in women include gynecological disorders, such as ruptured ectopic pregnancy, torsion (twisting) of a normal ovary, torsion of an ovarian cyst, acute salpingitis, endometriosis, spontaneous abortion, and degeneration of a fibroid especially during pregnancy. An acute abdomen may also occur with the worsening of chronic abdominal conditions.
Recurrent milder abdominal pain may suggest chronic illness such as chronic gastritis, pancreatitis, cholecystitis, hepatitis, peptic and duodenal ulcers, abdominal tumors, diverticulosis, Crohn's disease, ulcerative colitis, irritable bowel syndrome, gynecologic problems, or psychosomatic pain.
Risk for acute abdominal pain is related to the underlying cause, including disorders of major abdominal organ systems, vascular disorders, gynecologic disorders and presence of tumors. For chronic abdominal pain, risk is increased in individuals with chronic gastrointestinal disorders such as gastritis, cholecystitis, peptic and duodenal ulcers, diverticulosis, ulcerative colitis or irritable bowel syndrome.Incidence and Prevalence: Males and females are affected equally and incidence varies with the underlying cause or diagnosis. All age groups are affected although incidence increases with advancing age (King). Annually, more than 13.5 million individuals are seen in primary care settings for abdominal pain (Flasar). Abdominal pain accounts for 10% of all emergency room visits (King). |